Be the first line of defense and implement proactive strategies to identify and prevent pharmacy fraud in-house. Learn how to work with medical and pharmacy data together to further strengthen fraud detection and prevention efforts

Karen Weintraub
With 25 years of data and 20 years of healthcare experience, Ms. Weintraub is currently responsible for the design and development of the company’s healthcare fraud detection software products and services. She provides subject matter expertise on system design and workflow, business rule development, data mining and fraud outlier algorithms as well as SIU policies and procedures. Prior to joining Healthcare Fraud Shield, managed SIUs on various healthcare investigations for all commercial, Medicaid and Medicare business and claims of fraudulent activity. Ms. Weintraub received a BA in Criminal Justice from the University of Delaware and an MA in Criminal Justice from Rutgers University. Ms. Weintraub is a Certified Professional Coder for Payers (CPC-P), a Certified Professional Medical Auditor (CPMA) from the American Academy of Professional Coders, a Certified Dental Coder (CDC) from the American Dental Association, and the founder of the Hamilton, NJ AAPC chapter. She is also an Accredited Healthcare Fraud Investigator (AHFI) from the National Healthcare Anti-Fraud Association (NHCAA). Ms. Weintraub Taught CPT Coding, Fraud & Audits, and Medical Billing, Laws and Ethics and the local community college.
Healthcare Fraud Shield
Website: www.hcfraudshield.com
Healthcare Fraud Shield (HCFS) is a leading provider of fraud, waste, abuse, and error (FWAE) detection and payment integrity solutions for healthcare payers nationwide. Our platform stops improper claims before payment and detects issues after payment using advanced analytics, AI, and shared intelligence from a broad client network. With over 14 years of exclusive focus on FWAE and payment integrity, HCFS was built by industry experts to deliver measurable results. Clients typically achieve an average up to 10:1, and higher when leveraging HCFS Services.
Why HCFS:
- Enterprise-wide SaaS solution – Used by health plan teams across SIU/FWA, Payment Integrity, Risk, UM, Claims, Legal, Operations, and Finance
- 2,100+ FWAE rules – The largest FWAE rule library in the industry
- AI + Human-in-the-Loop – 11 AI models (FWA360Leads, AIShield, RecordPlus), all expert-validated
- Shared Analytics – Insights from 95M+ members across plans to uncover new, high-value cases beyond internal data
- 85+ external data sources – Enrich claims data for more precise detection
- Trusted by 70+ clients, including 7 of the 10 top commercial payers and 3 of the 5 of the top national payers








